Limited benefit of inversely optimised intensity modulation in breast conserving radiotherapy with simultaneously integrated boost

Hans Paul van der Laan*, Willemtje Dolsma, C Schilstra, Erik W Korevaar, Geertruida H de Bock, John H Maduro, Johannes A Langendijk

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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BACKGROUND AND PURPOSE: To examine whether in breast-conserving radiotherapy (RT) with simultaneously integrated boost (SIB), application of inversely planned intensity-modulated radiotherapy (IMRT-SIB) instead of three-dimensional RT (3D-CRT-SIB) has benefits that justify the additional costs, and to evaluate whether a potential benefit of IMRT-SIB depends on specific patient characteristics.

MATERIAL AND METHODS: 3D-CRT-SIB and various IMRT-SIB treatment plans were constructed and optimised for 30 patients with early stage left-sided breast cancer. Coverage of planning target volumes (PTVs) and dose delivered to organs at risk (OARs) were determined for each plan. Overlap between heart and breast PTV (OHB), size of breast and boost PTVs and boost location were examined in their ability to identify patients that might benefit from IMRT-SIB.

RESULTS: All plans had adequate PTV coverage. IMRT-SIB generally reduced dose levels delivered to heart, lungs, and normal breast tissue relative to 3D-CRT-SIB. However, IMRT-SIB benefit differed per patient. For many patients, comparable results were obtained with 3D-CRT-SIB, while patients with OHB>1.4 cm and a relatively large boost PTV volume (>125 cm(3)) gained most from the use of IMRT-SIB.

CONCLUSIONS: In breast-conserving RT, results obtained with 3D-CRT-SIB and IMRT-SIB are generally comparable. Patient characteristics could be used to identify patients that are most likely to benefit from IMRT-SIB.

Original languageEnglish
Pages (from-to)307-312
Number of pages6
JournalRadiotherapy and Oncology
Issue number3
Publication statusPublished - Mar-2010
Event27th Annual Meeting of the European-Society-for-Therapeutic-Radiology-and-Oncology - , Sweden
Duration: 14-Sept-200818-Sept-2008


  • Breast cancer
  • IMRT
  • 3D-CRT
  • Simultaneously integrated boost
  • Normal tissue

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